The invention relates to a vaginal speculum comprising two spoon blades which form a spoon blade assembly and:                are intended for introduction into the vagina;        are elongated; and        are located alongside and opposite one another;        
the one spoon blade at one end of the spoon blade assembly being provided with two bodies which together with said one spoon blade form a housing of essentially U-shaped cross-section and the other spoon blade being accommodated between said bodies such that it is hingeable with respect to the one spoon blade.
As is generally known, specula are used as a medical instrument by general practitioners, gynaecologists and currently to an increasing extent also by doctors' assistants (in the present text referred to below as the physician), for example to prepare smears and cultures and to investigate the positioning of contraceptive means, such as a coil.
The known specula have the disadvantages that they usually have ergonomics which are not woman-friendly, that operating handles and/or operating hands impede the view inwards and that the specula are not suitable for self-inspection.
The woman-unfriendly ergonomics are firstly revealed in the way in which a speculum is inserted. Insertion takes place by sliding the spoon blades in the closed position at an angle into the mouth of the vagina and then turning through a quarter turn. In practice, during this operation protruding operating handles or other external elements, as well as the physician's hand(s), come into contact with the back of the top of the thighs, the buttocks and/or other parts of the body of the woman, which is found to be unpleasant. Secondly, a speculum has two operating handles which are fixed to one another so that the spoon surfaces can be fixed—with some flexibility—in the spread position, after which the hold on operating handles of the speculum can be released. The woman also finds this fixed position unpleasant. Thirdly, it is difficult for the woman to “see what is going on” during the examination. This is because the ability to see is impeded by the position which she has assumed. It is more woman-friendly if the woman can follow the examination easily without additional effort. It is possible for the woman to view by means of a mirror which is fitted on the speculum or which is held and oriented by the physician or by the woman herself. In practice, however, this works only if the woman or the physician has two hands free for this. Furthermore, it is temporarily impossible for the examination to proceed because the mirror and/or the hands impede the physician's view inwards. In practice, the use of a mirror in this way results in a situation which is awkward and consequently unpleasant for the woman.
According to the prior art attempts are made to overcome the disadvantage that the operating handles and/or operating hands impede the view inwards during use by placing the operating handles at an angle of the order of magnitude of 30° to 60° to the spoon blades and/or making a sight opening in the spoon through which a view is obtained. However, this is even more disadvantageous with regard to woman-friendliness. After all, on the one hand the risk that the operating handles and the physician's hand come into contact with parts of the body of the woman when inserting the speculum increases as a result and, on the other hand, after the spoon blades have been fixed in the spread position the operating handles protrude at an angle with respect to the woman's body, which is found to be extremely unpleasant. Moreover, as a result of this positioning of the operating handles the woman is hardly able or unable to operate the operating handles herself. After all, in order to grasp these operating handles she would have to reach with one of her arms, wrist and hand in an unnatural and uncomfortable position from behind over one of her thighs, which in practice is hardly possible. Moreover, the woman still has to exert a squeezing movement on the operating handles, one side of which is in contact with her thigh or buttocks, as a consequence of which she still impedes the view inwards by her hand, wrist and/or lower arm, in any event during insertion and removal of the speculum, where it is important to have an unimpeded view inwards and of the mouth of the vagina.
Furthermore, specula known in the state of the art are found not to be suitable for self-inspection for one of more of the following reasons:                Firstly, the woman cannot support herself with one of her arms or hands during inspection because she needs both hands to operate the spoons and/or the retaining means which serve to fix the spoons with respect to one another.        Secondly—even if one hand suffices for operating the spoons—the operating hand has to assume a position which is unnatural, uncomfortable and impossible in practice.        Thirdly—even if one hand suffices for operating the spoons—the hand or operating handles block the view inwards while performing the squeezing movement that is necessary in order to be able to spread the spoon blades.        Fourthly, when inserting and operating the speculum the hand(s) impede(s) the view via the mounted mirror.        
One or more of these disadvantages can be overcome to a greater or lesser extent by making use of a gynaecological chair, but in the case of self-inspection, for example at home, a gynaecological chair will not be available and the disadvantages therefore remain insurmountable.
A vaginal speculum of the type mentioned in the preamble is disclosed in, inter alia, DE-A 74,364, U.S. Pat. Nos. 3,324,850, 5,072,720 and 5,052,372. Such specula are in general introduced, or at least partially introduced, into the vagina in a position in which they are rotated relative to the longitudinal direction of the spoon blades and are then turned through 90° into a use position. The spoon blades then have to be spread and fixed in the spread position in order to hold the speculum in place in the vagina. When the spoon blades of the speculum have not yet been spread or have not yet been adequately spread, the speculum has to be held in place by the operating person with one hand, since the muscular tissue in the vagina exerts a force on the speculum which has been introduced which tends to expel the speculum. Once the spoon blades have been adequately spread, these spoon blades act as a resistance element that counteracts expulsion.
U.S. Pat. No. 3,769,980 discloses a speculum which has attachments of a flexible, or at least semi-flexible, material fitted on the ends of the spoon blades. When the spoon blades are spread these flexible attachments ensure that the vaginal wall assumes an arc-like shape (literally “vaulting”) so that the cervix moves towards the mouth of the vaginal wall. However, this requires the hinge point about which the spoon blades hinge relative to one another to be a relatively long way outside the body in order to be able to stretch the mouth of the vagina to achieve the “vaulting” effect. This may be acceptable for performing an (early) abortion, but is uncomfortable for the patient and therefore undesirable for normal inspection purposes and taking smears.